COABE AARP Foundation Work For Yourself at 50+ Initiative Partner Application Survey

1.Organization Name:

2.Organization Address:

Address

City

3.Please select your state.

4.Organization Website:

5.Where is your program housed?

6.How many adult learners does your program serve annually?

7.How many learners over 50 does your adult education program serve annually?

8.Please note the demographic information that is currently being collected by your program.

9.Please select the following regarding your program:

Other (please specify)

10.Does your local program participate in COABE's Online Entrepreneurship Institute and/or does your program provide current entrepreneurship training for adult learners?

11.What is your current level of learner participation?

12.Share your organization's experience delivering business start up training or and/or business training courses. Include examples of training(s) that have been provided.

13.Selected organizations must either have capacity to deliver additional start up support and training or have a partnership in place with a local economic development/startup support organization to provide additional support after the initial WFY training. Please share details of your capacity and partnerships here.

14.Explain how your organization would provide or ensure additional startup support for participants.

15.Please provide at least one professional reference. Examples of acceptable references include workforce development board, state association, state agency.

16.Please indicate your name, email, and phone #.

First Name:

Last Name:

Email Address:

Phone:

17.Please indicate your primary occupation.

Other (please specify)